SLIDE 1
FTC Workshop on Clinical Integration in Health Care Thomas H. Lee, - - PowerPoint PPT Presentation
FTC Workshop on Clinical Integration in Health Care Thomas H. Lee, - - PowerPoint PPT Presentation
FTC Workshop on Clinical Integration in Health Care Thomas H. Lee, M.D. Network President, Partners HealthCare System Washington, D.C. May 29, 2008 Intro to Partners Community HealthCare, Inc. Partners Community HealthCare, Inc. The
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PCHI’s Vision
We will achieve our vision by: Taking a leadership role in creating new approaches to delivering, measuring and financing health care in the future Fostering an efficient and satisfying practice environment that allows clinicians to focus their energy and attention on high quality patient care Using technology to support clinical decisions and foster communication and collaboration among clinicians Working with employers and payers to develop payment mechanisms that recognize and reward the quality, efficiency and personalized service delivered by PCHI clinicians
Working together for better, safer, more cost- effective care
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PCHI’s Nuclear Cardiology Use Declining
Intervention mo_yr
- BCBS Pgm
Head Img Ed TAHP Pgm Back Img Ed
- Nuc Img Ed
- HPHC Pgm
2007- 9 2007- 8 2007- 7 2007- 6 2007- 5 2007- 4 2007- 3 2007- 2 2007- 1 2006-12 2006-11 2006-10 2006- 9 2006- 8 2006- 7 2006- 6 2006- 5 2006- 4 2006- 3 2006- 2 2006- 1 2005-12 2005-11 2005-10 2005- 9 2005- 8 2005- 7 2005- 6 2005- 5 2005- 4 2005- 3 2005- 2 2005- 1
24 22 20 18 16 14 12 10
_ X=15.96 +3SL=21.40
- 3SL=10.52
+2SL=19.59
- 2SL=12.34
+1SL=17.78
- 1SL=14.15
5 2 6 6 1
PCHI - Nuc. Card.
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Using Data to Track Performance
Specialist: Richard L. Curtis, M.D.
Gastroenterology Specialist Pharmacy Utilization Overview
(Year to Date thru Q1)
Generic Utilization Rate (%)
Statistics For Current Period
Patients With Number of Total Cost Specialis PCHI Specialty Group 104 3,096 8,797 $704,970 55.3 50.1 $31,945 351
- Avg. Cost Per Script ($)
$80.14 $91.01
40 80 120 160 200 240
(1) OTC OMEPRAZOLE (2) PREVACID (3) OMEPRAZOLE (4) PRILOSEC (5) PROTONIX (6) NEXIUM (7) ACIPHEX (8) PREVACID
- Avg. Cost for PPI Agents Prescribed by Gastroenterologists
Specialist DEA No.: AC2959926
25 50 75 100 125 150 175 200
Specialist PCHI Specialty Group
- Avg. Cost Per Script ($)
35 40 45 50 55 60 65 70
Specialist PCHI Specialty Group
Generic Utilization Rate (%) Top 5 Drugs (by Total Cost) Top 5 Drugs (by Total Scripts)
Drug Class Cost Scripts
- Avg. Cost
Per Script ASACOL MISCELLANEOUS GI $5,501 23 $239.18 OMEPRAZOLE PPI $3,396 30 $113.21 LIPITOR ANTIHYPERLIPIDEMICS $2,472 18 $137.36 ROWASA MISCELLANEOUS GI $1,967 8 $245.91 ACIPHEX PPI $1,616 11 $146.93 OTHER ALL $16,991 261 $65.10 Drug Class Scripts Cost
- Avg. Cost
Per Script OMEPRAZOLE PPI 30 $3,396 $113.21 ASACOL MISCELLANEOUS GI 23 $5,501 $239.18 LIPITOR ANTIHYPERLIPIDEMICS 18 $2,472 $137.36 NORVASC CALCIUM CHANNEL 16 $819 $51.17 ACIPHEX PPI 11 $1,616 $146.93 NEXIUM PPI 11 $1,491 $135.59 OTHER ALL 242 $16,648 $68.79
MESSAGE: YTD2004_Q1 Current Period:
Drug Number of Scripts (S Share of Scripts ( Avg Cost Per Script (Doc) Cost (Doc) Share of Scripts (Spec. Grp.) Group Avg Cost Per Script (Spec Grp OMEPRAZOLE 30 56% $113.21 $3,396 28% $146.26 ACIPHEX 11 20% $146.93 $1,616 9% $191.69 NEXIUM 11 20% $135.59 $1,491 28% $178.53 PROTONIX 2 4% $201.92 $404 33% $148.95 PREVACID 0% $0 0% $125.39 PREVACID 0% $0 1% $235.67 PRILOSEC 0% $0 1% $147.22
PPI Agent Utilization Specialist: Richard L. Curtis, M.D.
Gastroenterology Specialist Pharmacy Utilization Overview
(Year to Date thru Q1)
Generic Utilization Rate (%)
Statistics For Current Period
Patients With Number of Total Cost Specialis PCHI Specialty Group 104 3,096 8,797 $704,970 55.3 50.1 $31,945 351
- Avg. Cost Per Script ($)
$80.14 $91.01
40 80 120 160 200 240
(1) OTC OMEPRAZOLE (2) PREVACID (3) OMEPRAZOLE (4) PRILOSEC (5) PROTONIX (6) NEXIUM (7) ACIPHEX (8) PREVACID
- Avg. Cost for PPI Agents Prescribed by Gastroenterologists
Specialist DEA No.: AC2959926
25 50 75 100 125 150 175 200
Specialist PCHI Specialty Group
- Avg. Cost Per Script ($)
35 40 45 50 55 60 65 70
Specialist PCHI Specialty Group
Generic Utilization Rate (%) Top 5 Drugs (by Total Cost) Top 5 Drugs (by Total Scripts)
Drug Class Cost Scripts
- Avg. Cost
Per Script ASACOL MISCELLANEOUS GI $5,501 23 $239.18 OMEPRAZOLE PPI $3,396 30 $113.21 LIPITOR ANTIHYPERLIPIDEMICS $2,472 18 $137.36 ROWASA MISCELLANEOUS GI $1,967 8 $245.91 ACIPHEX PPI $1,616 11 $146.93 OTHER ALL $16,991 261 $65.10 Drug Class Scripts Cost
- Avg. Cost
Per Script OMEPRAZOLE PPI 30 $3,396 $113.21 ASACOL MISCELLANEOUS GI 23 $5,501 $239.18 LIPITOR ANTIHYPERLIPIDEMICS 18 $2,472 $137.36 NORVASC CALCIUM CHANNEL 16 $819 $51.17 ACIPHEX PPI 11 $1,616 $146.93 NEXIUM PPI 11 $1,491 $135.59 OTHER ALL 242 $16,648 $68.79
MESSAGE: YTD2004_Q1 Current Period:
Drug Number of Scripts (S Share of Scripts ( Avg Cost Per Script (Doc) Cost (Doc) Share of Scripts (Spec. Grp.) Group Avg Cost Per Script (Spec Grp OMEPRAZOLE 30 56% $113.21 $3,396 28% $146.26 ACIPHEX 11 20% $146.93 $1,616 9% $191.69 NEXIUM 11 20% $135.59 $1,491 28% $178.53 PROTONIX 2 4% $201.92 $404 33% $148.95 PREVACID 0% $0 0% $125.39 PREVACID 0% $0 1% $235.67 PRILOSEC 0% $0 1% $147.22
PPI Agent Utilization
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Making Performance Transparent to Drive Improvement
1
Practice Variation Report
HMA High Cost Radiology PCP Ordering October 01 2006 thru September 30 2007 (normalized for 1000 PT Panel) by Modality
John Doe1, MD John Doe2, MD John Doe3, MD John Doe4, MD John Doe5, MD John Doe6, MD John Doe7, MD John Doe8, MD John Doe9, MD John Doe10, MD John Doe11, MD John Doe12, MD John Doe13, MD John Doe14, MD John Doe15, MD John Doe16, MD John Doe17, MD John Doe18, MD John Doe19, MD John Doe20, MD John Doe21, MD John Doe22, MD John Doe23, MD
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“Carrots and Sticks” Drive EMR Adoption in the Community
0 % 1 0 % 2 0 % 3 0 % 4 0 % 5 0 % 6 0 % 7 0 % 8 0 % 9 0 % 1 0 0 %
2 0 0 3 2 0 0 4 2 0 0 5 2 0 0 6 2 0 0 7 L i v e I m p l e m e n t a t i o n
0 % 1 0 % 2 0 % 3 0 % 4 0 % 5 0 % 6 0 % 7 0 % 8 0 % 9 0 % 1 0 0 %
2 0 0 3 2 0 0 4 2 0 0 5 2 0 0 6 2 0 0 7 L i v e I m p l e m e n t i n g